Treatment of Pruritus Ani

SIR,-In discussing the treatment of painful phantom limbs Any Questions ? " April 24, p. 817) you rightly stress the disappointing results from such measures as excision of neuromnata, neurectomy, posterior radicotomy, and stump remodelling operations. Yotu conclude that " the management of these cases is distressingly difficult," but make no suggestion regarding treatment except to advise the patient to persist in the wearing of the prosthesis. Wh3le it is quite true that many heroic surgical measures, including even chordotomy, tend to be ineffective in this condition, it should surely be noted that excellent results are often obtained following 1% procaine injection of the sympathetic nerve supply to the affected limbs,' 2 3 4 or even from local injection of nerve trunks and scar tissue. The benefit so produced frequently passes off within a short time, but the procedure can be repeated indefinitely and the periods of remission tend to become longer, so that complete cure may result from three r four injections.